Dual Offset Metaphyseal-filling Stems in Primary Total Hip Arthroplasty in Dysplastic Hips After a Minimum Follow-up of Ten Years

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Dual Offset Metaphyseal-filling Stems in Primary Total Hip Arthroplasty in Dysplastic Hips After a Minimum Follow-up of Ten Years
Key Take-Away: 

The degree of stress shielding is not correlated with patient demographics, radiographic, or implant factors in dysplastic hips, as explained in this study. Considering radiographic bone changes around the stem, spot-weld formation (75.4%) was commonly noted at the border of the distal polished end (zones 3 and zone 5). The results of this study were nearly the same as previously published work depicting that bone remodeling occurred beyond the proximal metaphyseal area.

Introduction:

This study aimed to examine the long-term performance of tapered one-third proximally coated stems in patients with dysplastic hips.

 

Methods:

A total of 135 dysplasia patients (150 hips) who underwent a total hip arthroplasty were included in this study. They had a minimum follow-up of ten years. In every patient, single design tapered stems were used. At the time of surgery, there were 112 women (83%) and 23 men (17%) with a mean age of 45 years (23-72). Mean follow-up was 14.7 years (10-16.8). Before the operation, the Harris Hip Score and Merle D'Aubigne scale were used for clinical evaluation and at final follow-up. Implant survival was estimated via Kaplan-Meier survivorship analysis, with failure defined as a component revision for any reason.

 

Results:

Overall, one stem was revised for deep infection. No other femoral stem revisions than loosening, wear, periprosthetic fracture or instability was observed. Radiographic evaluation depicted excellent stem osteointegration in all the cases. The Kaplan-Meier survivorship, with stem revision for any reason as the endpoint, was 98% at 14 years (95% confidence interval 92.5 to 99.8).

 

Conclusion:

Dual offset tapered stem attained excellent survivorship and stability. There were also good clinical outcome scores with minimal thigh pain and stress shielding in arthritis and developmental dysplasia of the hip patients; a dual offset tapered stem may be an appropriate choice for primary total hip arthroplasty in this group.

Source

Int Orthop

Link:

https://www.ncbi.nlm.nih.gov/pubmed/30232526

Original title of article:

Dual offset metaphyseal-filling stems in primary total hip arthroplasty in dysplastic hips after a minimum follow-up of ten years

Authors:

Goksel Dikmen et al.

 

Exploratory, Pain, Dysplasia, Hip, Thigh, Harris Hip Score, Merle D'Aubigne scale, Kaplan-Meier survivorship analysis
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